Pharmaceutical Administration and Regulations in Japan - Nihs

CHAPTER 6
Health Insurance Programs
and Drug Pricing in Japan
1. HISTORY OF HEALTH INSURANCE
PROGRAMS
Health insurance programs in Japan
began in 1922 with enactment of the Health
Insurance Law which was aimed only at
workers for the purpose of ensuring sound
development of national industries through
increases in labor efficiency and close
cooperation between workers and employers
by eliminating workers' anxiety about their
daily life. This law was implemented in
1927. The National Health Insurance Law,
enacted in 1938, and the Employees’ Health
Insurance Law and the Seamen's Health
Insurance Law, both enacted in 1939, were
subsequently enforced. In 1961, it was
ruled that every citizen was required to join
either one of the various industry-managed
employees' health insurance programs or the
NHI, which is a regional insurance program.
At this point, "health insurance covering the
entire population" was established.
Increasing efforts were made thereafter to
improve the structure of medical benefits
Pharmaceutical Regulations in Japan:
given under various health insurance
programs. In addition, under the Law for the
Welfare of the Aged, all medical costs for the
elderly have been provided free of charge
since 1973. These measures all helped to
alleviate the burden placed on patients by
high medical costs.
Because of the long-term deficit in the
health insurance system, radical measures
as well as temporary financial measures
were conceived.
Free medical care for the elderly resulted
in sharp increases in the cost of their medical
treatment, which seriously affected the
financial status of the health insurance
program. In addition, it created an
imbalance in the contributions for medical
costs of the elderly between the different
health insurance programs due to differences
in the proportion of elderly persons covered
under each program. This made it
necessary to radically review the health
insurance system in Japan, and as a result,
the Health and Medical Services Law for the
Aged was enacted and was enforced in
1983.
This law encourages general health
related projects for the elderly, including the
prevention and treatment of diseases and
rehabilitation efforts. A new system was
introduced in which medical costs for the
elderly are shared by public expenditure and
by contributions from individual health
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